Acute Kidney Failure – Ayurvedic Herbal Treatment

Kidney failure of a short duration is known as acute kidney failure, and can be due to prerenal causes, postrenal causes and renal causes. Prerenal causes account for nearly 60-70% of this condition, and result from insufficient blood supply to the kidneys due to dehydration, a drastic drop in blood pressure, and a heart attack or heart failure. Post renal causes account for only 5-10 % of this condition, and result from obstruction to the flow of urine due to kidney stones, tumors, enlarged prostate or other causes. Renal causes account for 25-40% of this condition, and result from damage to the renal blood vessels or actual kidney tissue due to infection, inflammation or injury.

Acute kidney failure needs to be treated in a hospital, with a focus on supplementing or replacing the filtration function of the kidneys, and treating the specific cause of the condition. Limitation of oral fluids, correction of dehydration and electrolyte imbalance and steps to improve blood circulation and blood pressure are standard hospital procedures.

Ayurvedic medicines can be used to treat prerenal causes like a low blood pressure, because of which the kidneys do not get sufficient blood circulation. Medicines like Nardiya-Laxmi-Vilas-Ras, Maha-Laxmi-Vilas-Ras, Siddha-Makardhwaj-Ras and Hem-Garbha-Ras can be used for this purpose. Other prerenal causes like a heart attack can be treated using medicines like Bruhat-Vat-Chintamani-Ras, Shrung-Bhasma, Arjunarishta, Dashmoolarishta and Punarnavasav. Postrenal causes like an enlarged prostate or a tumor are treated using medicines like Chandraprabha-Vati, Gokshuradi-Guggulu, Punarnavadi-Qadha, Trivang-Bhasma, Suvarna-Raj-Vangeshwar-Ras, Kanchnaar-Guggulu, Triphala-Guggulu, Suvarna-Bhasma and Heerak-Bhasma.

Ayurvedic medicines are especially useful in treating renal causes resulting in acute organ failure, which include diseases like glomerulonephritis, acute interstitial nephritis and acute tubular necrosis. Medicines like Chandraprabha-Vati, Gokshuradi-Guggulu, Maha-Manjishthadi-Qadha, Saarivasav, Chandrakala-Ras, Sutshekhar-Ras, Punarnavadi-Guggulu, Punarnavadi-Qadha, Shankh-Vati, Panchamrut-Parpati, Yava-Kshar and Surya-Kshar are very effective in treating these conditions. In addition, medicines which act on the “Rakta” and “Meda” dhatus (tissues) are also quite helpful in these conditions. These medicines include Patol (Trichosanthe dioica), Saariva (Hemidesmus indicus), Patha (Cissampelos pareira), Musta (Cyperus rotundus), Kutki (Picrorrhiza kurroa), Nimba (Azadirachta indica), Triphala (Three fruits) and Kutaj (Holarrhina antidysentrica).These medicines increase the blood flow to the kidneys and thus increase the filtration rate. In addition, these medicines help to heal injured kidney tissue and thus preserve kidney function. The combined action of these medicines helps in removing impurities from the blood at a faster rate and this helps considerably in reducing or removing associated symptoms like confusion, lethargy, fatigue and nausea and vomiting.

Since acute kidney failure is a serious condition, all such patients need to be under the regular care and supervision of a nephrologist, both during hospitalization and also in the post hospitalization stage. Ayurvedic medicines can be added in the medical management so as to improve the chances of recovery and reduce long-term complications.

Rooibos Tea Benefits: 7 Reasons You Should Drink Some NOW

Rooibos tea, from the South African red bush plant, has long provided fast, flavorful relief from many common maladies. Headaches, stomach aches, skin problems, and allergies can all be alleviated through the regular consumption of this herbal tea. But that’s just the beginning – here are seven more remarkable Rooibos tea benefits… so drink up!

Powerful Antioxidants & Flavonoids

Just as air makes metal rust, there are atoms called free radicals that attack the cells of our body. The damage caused by free radicals can lead to a domino effect of aging, illness, heart disease and cancer. The natural antioxidants and flavonoids found in red bush attack and halt this damage, reducing the likelihood of wrinkles, stroke, and heart disease. The plant also contains a particular flavonoid called aspalathin, found nowhere else in nature, which research has shown to have effects similar to Vitamin E.

Healthy Hydration

Black tea and green tea have been making headlines as promoting good health with antioxidants and flavonoids, and Rooibos is fast gaining popularity for the same reasons. Unlike the black and green varieties, however, Rooibos tea is caffeine-free and the naturally sweet flavor typically means fewer (if any) sweetener needs to be added.

Silky Smooth Skin

Staying properly hydrated is only one way of keeping skin healthy and silky smooth. The antioxidant properties of red bush tea fight against skin damaging free radicals. Both drinking and external use of this South African tea benefits skin by reducing inflammation from eczema, acne, psoriasis, and even diaper rash.

Love Your Heart

Drinking Rooibos tea benefits blood vessel health and reduces inflammation, thereby reducing strain on the heart. The antioxidants benefit the heart another way as well; too much oxygen can actually cause damage to the body; this is called oxidative stress. A balance between oxidants and antioxidants is an important factor to deterring heart disease.

A Balanced Beverage

Unlike sodas, artificially flavored fruit drinks, coffee, or alcohol, drinking Rooibos tea benefits your health in many ways. Naturally sweet and calorie free, this tea doesn’t add unwanted calories and it is safe for diabetics. It also contains 9 essential minerals and fluoride, and is very low in tannins.

Something To Smile About

Red bush contains calcium and trace minerals that work to keep teeth strong and healthy. This tea benefits your smile in others ways as well. It contains fluoride that can help prevent plaque formation and the ensuing periodontal disease it can cause.

Sweet Dreams And Calm Tummies

Babies of South Africa are frequently given this healthful tea to provide relief from digestive troubles and to help them sleep. Healthy or ill, these children reap the same benefits as adults from red bush tea: antioxidant protection, improved hydration, and better dental health.

Red bush tea can be found in many supermarkets, health food stores and from online distributors that specialize in this unique tea. Try Rooibos tea today for a lifetime of benefits and good taste!

Guide to Haunted Lighthouses – Massachusetts

Massachusetts, well known for Plymouth Rock, where the first pilgrims landed, and the Salem witch trials, is also home to five of America’s most haunted lighthouses.

The Haunted Bell

Baker’s Island Light

Baker’s Island Light, just six miles off the coast of Salem, home of the infamous witch trials, is reputedly haunted by a phantom foghorn bell.

This mechanized bell sounded a warning to sailors of impending danger, and rang just once, before being struck by lightning that destroyed it. The lighthouse keeper had to go out in the storm and manually strike a hammer against the bell at precise intervals to keep mariners safe. The bell was replaced, but the new bell repeatedly failed and the frustrated keeper left his post.

Seventeen years later while visiting the lighthouse by steamer, the keeper and his fellow passengers heard the bell. After dropping a few passengers off at a nearby harbor, a waterspout suddenly rose from the sea, capsizing the boat and drowning all but a few passengers. The former keeper, who survived, believed the bell was sounding a warning.

According to legend, this bell, also destroyed by lightning, can be heard sounding the alarm even when there is no apparent danger.

The Ghost Walk

Boston Harbor Light

Boston Harbor Light on Little Brewster Island was the first lighthouse built in the pre-revolutionary war colonies. The original structure, cone shaped and first lit by candles, and later oil lamps, was destroyed by the British Army garrisoned in Boston, after colonial militiamen twice attacked it.

When the war was over, a new tower was erected, that stood 75 feet above the sea, and prevailed against hurricanes, gale force winds and high seas for more than 200 years. A new Fresnel lens was installed in 1859, making Boston light visible for sixteen miles.

Little Brewster had its share of shipwrecks, though not as many as other lighthouses. Sailors still speak of a “ghost walk” several miles from the island, where the lighthouse signal cannot be heard. New Englanders and others believe this area is haunted.

The Pirate Keeper

Bird Island Lighthouse

The first keeper of Bird Island Lighthouse was alleged pirate, William Moore. Moore, who fought against the English in the War of 1812, owed the government enough money to justify their banishing him to the lonely life of a lighthouse keeper.

He was assigned to Bird Island Light in 1819, taking his wife who apparently married him when he was financially prosperous. Mrs. Moore, suffering from tuberculosis and addicted to tobacco, was forbidden to leave the island, as her husband feared that once gone, she would never return.

The dampness of the lighthouse aggravated her condition, and her desperation for tobacco so distressed her that people on the mainland could hear her cries. The local doctor implored Moore to allow her tobacco, but he staunchly refused. The townspeople, disturbed by her wailing took pity on her and smuggled tobacco to her, despite fearing her husband.

When she finally died, Moore raised the distress flag, and a minister went to the island, performed the funeral rites and laid her to rest. The angry townspeople blamed Moore for her death, and he in turn blamed them for not respecting his wishes. Rumors flew that Moore murdered her and covered up the true cause of her death.

According to legend, several of Moore’s successors reported seeing an old woman’s ghost, hunched over, knocking at the door late at night.

The Long Goodbye

Gurnet (Plymouth) Light

Gurnet, or Plymouth Light, America’s oldest wooden lighthouse dating back to the Revolutionary War, is also one of its most haunted.

Today, the Coast Guard operates Plymouth Light, yet many believe the spirit of a former keeper’s wife haunts its rooms, waiting for her husband’s return.

Hannah stayed behind to tend the light while her husband went off to fight for America’s Independence from Great Britain. Her neighbors noticed her standing vigil at her window each evening, waiting for her husband, who unfortunately was killed in action.

Some say Hannah still keeps her faithful vigil, briefly appearing at the window, and then quickly vanishing from sight.

Warning Cries-Nightly Shadows

Minot’s Ledge Light

Minot’s Ledge Light is no more than a tower that sits on a reef jutting out to sea off the coast of Scituate. The first tower lasted less than a year before an angry sea claimed it.

Isaac Dunham, the first keeper at Minot’s Ledge urgently warned his superiors about the lighthouse’s instability to no avail, and he retired after fourteen frustrating months.

One day, Dunham’s successor, John Bennett flew a flag from the lighthouse indicating he needed a ride to shore. He left his two assistants, Joe Wilson and Joe Antoine in charge, when suddenly a savage nor’ easter packing one hundred mile an hour winds attacked them. Bennett watched helplessly from shore as the storm destroyed the lighthouse, killing his two assistants.

Several fishermen reported seeing Antoine swinging from a ladder, yelling, and “Stay away!” in his native Portuguese. Subsequent keepers reported seeing shadows in the lantern room, hearing ghostly whispers at night, and hearing or feeling soft taps upon their shoulders. The two Joes used these taps to signal the end of a shift. One keeper, hearing the taps committed suicide, and another went insane and was taken to shore in a straight jacket.

Then there are the windows…It generally takes an entire day to clean windows soiled by overhead seagulls, yet each new keeper’s assistant reported the windows sparkling clean before ever reaching them.

Are these stories truth or legend? Visit one and find out.

Female Hair Loss On Sides, Temples, And Around Edges

Female hair loss that occurs in the temple area, edges, or sides of head could be caused by several different disorders.

Frontal Fibrosing Alopecia

Frontal fibrosing alopecia is a newly discovered condition. It was first described in 1994. Characteristics include symmetrical hair loss along the top hairline and the sides of scalp. Complete or partial eyebrow loss can also occur. This condition does not happen suddenly. It is a slow, gradual process. The bald area progressively recedes farther and farther back, forming a “band” around the top and side edges that resembles a receding hairline. The baldness can extend as much as five inches past the original hairline. There may be a slight or noticeable contrast in the appearance of the skin in the affected area. It may appear pale or mildly scarred.

The condition was originally named “postmenopausal frontal fibrosing alopecia” as it was originally thought to only affect women of postmenopausal age. Now it is being seen in younger women as well. Although it was once considered very rare, it is increasingly becoming more common. The cause is unknown but there is speculation that the immune system and/or hormonal system may be involved.

Because it is a type of cicatricial alopecia, scarring occurs under the surface. The scarring creates a closure over the affected follicle, making it impossible for that follicle to ever produce hair again. Treatment revolves around stopping the progression rather than trying to re-grow the hair that has already been lost. Early intervention is necessary.

Alopecia Ophiasis

Ophiasis is a more severe and dramatic variation of alopecia areata. A pattern of baldness occurs at the temples, behind the ears, along the sides, and extending to the nape (or entire occipital area) of the neck. The bald areas often occur on one side or in one area first, gradually connecting together to form a band around the perimeter of scalp on the sides and along the bottom of neck area. Ophiasis is a Greek word meaning serpent, referring to the snake-like pattern that is formed as this condition progresses.

With alopecia areata in all its various forms, the follicles are not damaged or destroyed so there is always the possibility of regrowth. The prognosis for ophiasis is not as positive as it is in less severe forms of this disorder, but as long as the follicles are still alive the opportunity is there. Early intervention provides better results.

Because it is an autoimmune disorder, proper treatment would include calming, nourishing and balancing (but not over-stimulating) the immune system, as well as treating the hair loss itself. Autoimmune disorders require specific anti-inflammatory diet that may also require elimination of gluten and other possible food allergens. Natural or synthetic agents may be used to encourage follicle stimulation and new growth.

Traction Alopecia

Traction is one of the most common causes of temporal thinning in women and girls. This occurs from wearing tightly pulled hairstyles consistently for prolonged periods of time. The sustained tension on the scalp strains the follicle, causing the underlying strand to loosen from the follicle. Persistent tension may eventually damage the follicle.

Treatment involves wearing hair loose as much as possible and massaging area with essential oils, coconut oil or jojoba to provide nourishment and circulation to follicles. Early detection is necessary as scarring can occur with this condition. Once scarring occurs, hair loss is permanent.

Correct Coding of Skin Lesions

Procedures on skin can be some of the most difficult to code because of the many categories of lesions, location of lesions, number of lesions, diameter of lesions, incomplete documentation, and the terminology used by physicians. Here are some guidelines for correct coding of skin lesions:

Lesion Categories

Lesions are categorized as skin tags, warts, neoplasms, or masses/lumps (cyst, tumor). First consult the ICD-10-CM Index for the term documented. For example, cysts are categorized to the tissue in which they are found. If the documentation shows the cyst or lesion was removed from skin tissue, find the term Cyst, followed by the sub term skin, followed by the type of cyst.

Neoplasms can be either malignant, benign, uncertain behavior, or unspecified behavior. Malignant lesions can be primary, the first site of malignancy; secondary, site where primary malignancy has metastasized or “spread”; and carcinoma in situ, an early form of cancer defined by the absence of invasion of tumor cells into the surrounding tissue.

Benign lesions are not malignant and do not metastasize or “spread” to other parts of the body. Benign lesions look similar to the tissue where the lesion originated and grow slowly. Though benign lesions are not cancerous, they may cause problems because of their location and often there are multiple benign lesions which can cause adverse effects on the body.

Lesions of uncertain behavior are categorized as uncertain when the lesion has not been identified as malignant or benign. The physician needs to document uncertain behavior in order for this category to be used. Usually, uncertain behavior is documented on preoperative diagnoses and documentation prior to surgical removal and submission to pathology. The pathologist will then clarify whether the lesion is benign or malignant.

Lesions of unspecified behavior are lesions where there is absence of documentation of benign, malignant, or uncertain. This is the “catch all” category and should be used as little as possible.

Location of skin lesions

Skin tissue has three main layers which are divided into sub layers. The location of the skin lesion in the skin layers will determine the code category that is used.

The epidermis is the outermost main layer of skin. This layer includes the stratum corneum (horny sub layer), followed by the keratinocytes (squamous cells sub layer), and finally the basal sub layer. The horny sub layer is continuously shed and prevents foreign substances and loss of fluid from the body. The squamous cells sub layer lies just beneath the horny sub layer. The basal sub layer is the deepest sub layer of the epidermis. Throughout the epidermis are melanocytes, specialized cells which produce melanin (skin pigment).

The second main layer of skin tissue is the dermis, also called the middle layer. Blood vessels, lymph vessels, hair follicles, sweat glands, collagen bundles, fibroblasts, and nerves are located in this layer. The dermis is held together by collagen. The dermis is flexible and strong. Because the nerves are located in this layer, this is where pain and touch receptors are located.

The third main layer of skin tissue is the subcutaneous layer. The subcutaneous layer is also known as subcutis, meaning under the skin. This is the deepest layer of skin made of collagen and fat cells. This layer helps preserve body heat and protects against injury by acting as a barrier.

Common terminology for skin lesions

Physicians may use a variety of terminology to describe lesions of the skin, even within the same document. The lesion may be described as a cyst, sebaceous cyst, tumor, subcutaneous mass, soft tissue lesion, skin tag, and wart, etc.

When coding skin lesions and their removal, try not to get caught up in the terminology and stick to the facts. The ICD-10-CM table of neoplasm has clear instructions and guidance on coding skin lesions. “Where such descriptors [malignant primary, malignant secondary, carcinoma in situ, benign, uncertain behavior, or unspecified behavior] are not present, the remainder of the Index should be consulted… ” [CMS.org ICD-10-CM]

The coder should always first consult the Index for the terminology used by either the physician or the pathologist. The Index will lead the coder to the correct section of the ICD-10-CM Tabular List.

Important Facts the Coder Needs to Know

  • Where was the lesion located? Skin, bone, muscle…
  • Size of lesion in centimeters?
  • Type of wound closure? Simple, intermediate, complex…
  • Length of closure in centimeters?
  • What was actually done to the lesion? Biopsy, removal, shaving, excision…

Code selection is based on a number of factors including the answers to the above questions. By first consulting ICD-10-CM Index and then Tabular List, this will help guide your procedure code selection. If a benign tumor is excised from the soft tissue in the left arm, the procedure code will reflect excision of lesion from soft tissue or connective tissue, upper left extremity. It would be inappropriate to select codes from the skin category for either the diagnosis or procedure codes as this particular tumor was in the soft tissue.

Common Procedures for Skin Lesions

Some of the most common procedures for skin lesions include biopsy, shaving, excision, destruction (cryotherapy and electrosurgical), cutting or paring, debridement, excisional debridement, and curettage. Depending on whether the procedure is performed as an inpatient (ICD-10-PCS) or outpatient (CPT®) will guide your procedure code selection.

ICD-10-PCS Inpatient Procedures for Skin Lesions

Excision is defined in ICD-10-PCS as cutting out or off without replacement some of a body part with the use of a sharp instrument including scalpel, wire, scissors, and bone saw, electrocautery, etc. The qualifier DIAGNOSTIC is used to identify excisions that are biopsies in ICD-10-CM.

Destruction is defined as eradicating without replacement some/all of a body part so that the body part is no longer there. Destruction is accomplished with the use of direct use of energy, force, or a destructive agent. None of the body part is taken out and therefore there will most likely not be a pathology report on lesions removed by this method.

Extraction is defined as pulling or stripping out or off all or a portion of a body part (by use of force either manual or suction. The qualifier DIAGNOSTIC is used to identify extraction procedures that are biopsies. Debridement and curettage would fall under this category.

Outpatient Procedures for Skin Lesions

Definitions for CPT® procedures are included in the AMA CPT® Code Book. Procedures used to treat skin lesions include biopsy, shaving, excision, destruction (cryotherapy and electrosurgical), cutting or paring, excisional and non-excisional debridement, and curettage.

Biopsy is the removal a sample of the lesion and submitted to pathology. The pathologist will evaluate the lesion under the microscope and help guide the care required for treatment of the lesion by identifying the type of lesion in the sample. At times, the entire lesion may be removed as a biopsy sample.

Biopsies that are documented as shave biopsies are either coded to biopsy codes or shave excision codes. There is not a CPT® code that directly correlates with shave biopsy. Review the documentation carefully. Match the documentation to the CPT® code description.

Excision is the removal of the lesion completely with margins and submitted to pathology.

Destruction employs heat, freezing, chemicals, lasers and/or curettage to destroy the lesion in place. Destruction does not usually leave any material as specimen to be submitted to pathology.

Cutting or paring involves the use of a blade, curette, or similar sharp instrument. Paring and shaving involve removing the lesion just to the level of the skin, similar to scraping.

CPT® code selection is based on anatomic location (arms, legs, trunk, face, nose, etc.) and size of the lesion in centimeters. The physician must document the size of the lesion either in width and length or diameter. Be careful not to confuse the wound closure length with the lesion size. These are often very different measurements.

Lesion Excision and Margins

For outpatient procedure coding, it is important to include the margin of the lesion in the size of the excision code. CPT® Code Books instruct the coder to select codes based on the greatest clinical diameter of the lesion plus the margin required for complete excision. Code selection is based on the sum of the size of the lesion and its margins.

For example:

3.4 cm lesion of the upper back excised

1.5 cm surrounding margin

Total sum of excision 4.9 cm.

Coding Excision of Multiple Lesions

CPT® Code Books have detailed instructions on the code selection for removal of multiple lesions in the same operative session.

First, the coder must report separately each lesion excised. Select the code based on the diameter of the lesion plus the narrowest margin.

Second, closure of the defects created by the excisions is reported when the closure is intermediate or complex. Simple closure is included in the excision code and is defined as involving primarily epidermis and dermis or subcutaneous tissues. Simple closure requires a simple one layer closure and includes the local anesthesia and chemical or electrocauterization of wounds not closed by suture.

Intermediate closure is defined as layered closure. Intermediate closure also includes simple closure of heavily contaminated wounds that require extensive cleaning.

Complex closure is defined as requiring more than layered closure including extensive undermining of the wound, retention sutures, and skin grafting procedures.

CPT® Code Book instructs the coder “when multiple wounds are repaired, add together the lengths of all those in the same classification [simple, intermediate, or complex] and from all anatomic sites that are grouped together into the same code descriptor [i.e., closure of wound defects of multiple upper extremity lesion excisions would be grouped together; closure of wound defects of the back would be grouped together].

For example:

A) 2.3 cm benign lesion of upper right arm with 1 cm margins. Intermediate closure.

B) 2.5 cm benign lesion of upper left arm with 1 cm margins. Intermediate closure.

C) 1.2 cm benign lesion of upper right arm with 1 cm margins. Simple closure.

D) 2.5 cm benign lesion upper left thigh with 1 cm margins. Intermediate closure.

E) 3.2 cm benign lesion of upper left thigh with 1 cm margins. Intermediate closure.

ICD-10-CM diagnoses:

Benign lesion right forearm

Benign lesion left forearm

Benign lesion left thigh

CPT® procedures:

Excision benign lesion trunk, arms, or legs 3.3 cm [lesion A]

Excision benign lesion trunk, arms, or legs 3.5 cm [lesion B]

Excision benign lesion trunk, arms, or legs 2.2 cm [lesion C]

Excision benign lesion trunk, arms, or legs 3.5 cm [lesion D]

Excision benign lesion trunk, arms, or legs 4.2 cm [lesion E]

Intermediate repair wounds of scalp, axillae, trunk, and/or extremities (excluding hands/feet) 3.3 cm [lesion A] + 3.5 cm [lesion B] + 3.5 cm [lesion D] + 4.2 cm [lesion E] = 14.5 cm

Simple repair wounds of scalp, axillae, trunk, and/or extremities (excluding hands/feet) 2.2 cm [lesion C] = 2.2 cm

Avoid Costly Coding Mistakes

By following these rules for correct coding of skin lesions and their removal, the coder can help avoid costly coding mistakes. Many coders feel comfortable coding directly from the operative report. However, when there are multiple procedures or lesions removed, it is best to sort out the facts before attempting to select codes. Follow these steps in order to avoid coding mistakes:

  1. Review all of the documentation on the medical record.
    • Note lesion location(s)
    • Lesion size including margin
  2. Do not use the pathology report for this information. The process of preserving the specimen alters the size of the lesion.
  3. Type of lesion(s)
    • Cyst
    • Wart
    • Benign neoplasm
    • Malignant neoplasm
    • Uncertain neoplasm
    • Unspecified neoplasm
  4. Exact procedure for each lesion
    • Biopsy
    • Excision
    • Destruction
    • Shaving
    • Cutting
    • Paring
    • Debridement
    • Curettage
  5. Closure type and length for each wound
  6. Select ICD-10-CM code(s) to appropriately report the lesion(s). Multiple lesions of the same anatomic site are coded only once for the ICD-10-CM diagnosis code.
  7. Review the operative note carefully to determine lesion size(s) and type(s) of wound closure.
    • For inpatient encounters, select the ICD-10-PCS procedure code(s) appropriate to report the procedure(s). **is graft included??
    • For outpatient encounters, select the CPT® procedure code(s) appropriate to report the diameter plus margin for the lesion(s).
    • For outpatient encounters, select the CPT® procedure code(s) appropriate to report the closure of the wound defect for the lesion(s). Multiple wound closures in the same anatomic site are coded together by adding the sum of the lengths of the closure(s) of the same type [intermediate or complex].
  8. Add modifiers to CPT® procedure codes are required. See Modifier 59 rules.

By carefully reviewing medical record documentation for category of lesion, lesion location(s), and the terminology used by physicians and pathologists, the coder can appropriately code and expect reimbursement for inpatient and outpatient procedures on skin lesions. Using these guidelines, the coder can avoid costly coding mistakes and need for future rebills.

What Causes Shortness of Breath?

Shortness of breath is also known as Dyspnea which is one of the scariest conditions that happens to human beings. Shortness of breath occurs if you cannot get enough air inside the lungs. If it occurs in severe condition, then it is recommended to consult with your doctor as early as possible.

Shortness of breath is potentially a life threatening emergency that causes serious diseases like heart attack, pulmonary embolism etc. Shortness of breath can be identified while running. If you feel some difficulties while running, then you can confirm as shortness of breath. In such cases, you have to consult with your doctor. Even shortness of breath occurs in low oxygen at high altitude places like hill stations.

There are many causes and diseases for shortness of breath which results in heart disease, muscle and nerve diseases and anxiety etc. The possible causes and diseases that occur due to shortness of breath are as follows:

1) Heart valves may be leaky.

2) During exercise, the heart muscles do not get enough blood.

3) Heart muscles may be stiff.

4) Opening in the heart which stops the lungs from getting enough oxygen inside and also inside the blood.

5) High blood pressure can cause which is also known as pulmonary hypertension.

6) Carbon monoxide poisoning

7) Asthma, which is a breathing disease that occurs at regular intervals. It can occur while running or dancing. Even asthma can occur if entered in to dusty areas.

8) Pneumonia

9) Congestive heart failure

10) Bronchitis

11) Collapsed lungs which are otherwise known as pneumothorax.

12) Muscular dystrophy

13) Polymyositis

14) Dermatomyositis

15) Acidosis which is aspirin poisoning

16) Even kidney failure is also a cause for this shortness of breath.

The following above are the major cause of shortness of breath. Apart from these, other causes are also possible. They are:

1) Hyperventilation- this causes when breathing too fast which results in feelings of panic.

2) Gastro esophageal reflux- stomach acids that splash up into the throat.

3) Low level of physical fitness which is called as Deconditioning.

4) Postnasal discharge- this occurs when sinus drainage collects in the back of the throat.

10 Simple and Natural Home Remedies For Asthma

Asthma is a long-term disease that has already affected millions of people all around the world. It is generally caused by allergies to certain substances such as dust, gases, smoke, pollens, foods, animal dander, cold weather, environmental changes, etc. Coughing, wheezing, difficulty in breathing, and tightness in chest are some of the major symptoms of this disease.

One must control asthma as it is a life-threatening and serious disease. Although asthma is a chronic disease, it is treatable. Read this article to find the best natural home remedies for asthma. These natural remedies help reduce the severity of the disease and relieve the various symptoms associated with it. These home remedies are very simple and one can easily follow them in the comfort of their home.

Asthma Home Remedies

* The first thing you need to do is to know various allergens that may trigger the symptoms, and try to avoid them.

* Take one teaspoon turmeric (haldi) powder two times a day along with warm water. This is an effective home remedies for asthma.

* Prepare a decoction by boiling equal quantities of ginger (adrak), holy basil (tulsi) and black pepper (kali mirch). Take this mixed with half a teaspoon of honey.

* Another useful home remedy for asthma is honey and ginger juice. Take one teaspoon of honey along with few drops of fresh ginger (adrak) juice on an empty stomach in the morning.

* Boil some carom seeds (ajwain) in water. Inhale the fumes produced by this hot solution. This helps relieve chest congestion.

* Carom seeds (ajwain) are also beneficial in reducing the excessive production of phlegm. Take carom seeds in the form of powder twice daily, or prepare a decoction and take it warm. This remedy is taken especially in bronchial asthma, when phlegm remains stuck in the bronchioles.

* The smoke that is obtained by burning asafoetida (hing) can be inhaled to get relief from spasms of bronchial asthma.

* Boil two or three cloves of garlic (lahsun) to a glassful of milk for five minutes. Drink hot to get relief from asthmatic symptoms.

* Another simple home remedy for asthma is mint. It is well known for its property of decreasing phlegm. Crush fresh mint leaves to extract its juice. Add equal amount of ginger (adrak) juice in mint juice. Take 8-10 ml of this mixture two times a day, along with honey.

* Holy basil (tulsi) is a valuable herb known for its anti-asthmatic properties. Crush few fresh leaves of holy basil and extract the juice. Mix basil juice with few drops of ginger (adrak) juice and some honey.

Copyright © Ryan Mutt, All Rights Reserved. If you want to use this article on your website or in your ezine, make all the urls (links) active.

Benefits Of Honey And What Is Wild Forest Black Honey?

Honey is a natural antiseptic which is effective to wounds healing by killing the bacteria on the wounds. Other than anti-bacterial,honey also draws body fluids and nutrients to the wound area that can accelerate the healing.Honey has been popular for thousands of years due to its unique nutritional content. It is a natural antiseptic which is effective to wounds healing by killing the bacteria on the wounds. It contains glucose and fructose that are ready absorbed by the body, amino acids which include 8 essential ones, over 20 kinds of minerals, over 20 kinds of vitamins and enzymes.

Research shows that honey improves chronic bronchitis, bronchial asthma, sinus problems, and allergies.

1. Honey has been used to combat depression, fatigue, insomnia, nervous disorders, urine retention, cramps, headaches, and high blood pressure.

2. Honey beautifies and soothes the skin, clears many skin disorders.

3. Honey hastens the healing of wounds.

4. Honey facilitates the digestion and assimilation of other foods.

5. Honey has laxative, sedative, anti-toxic, and antiseptic effects.

6. Honey is effective in countering anemia.

Honey can be a good substitute for sugar in our daily consumption of drinks and food. On top of that, it is effective for treating many medical diseases. Honey contains sugars like glucose and fructose and minerals like magnesium, potassium, calcium, sodium chlorine, sulphur, iron and phosphate. It provides us vitamins B1, B2, C, B6, B5 and B3 and contains copper, iodine, and zinc in small quantities.

Black Wild Honey is harvested from the dense tropical rain forest along the ‘Titiwangsa” mountain range. Amongst the different types of honey being harvested, Giant B only chooses the best grade of pure black wild natural honey to serve our valued customers. Black wild honey is made up of flower nectar, pollen and other natural extractions. Black wild honey is rich in vitamins, amino acids, minerals and enzymes. It has a superior nutrition profile as it is not subjected to any form of human activities interference, contamination or pollution. Pure honey is made up of two main sugars, Fructose and Glucose. These are Monosaccharides or simple sugars. These sugars can be absorbed by human body directly without digestion. Pure honey is natural preservative and can be stored indefinitely.

These are main studies proved that pure wild honey has a series of medicinal values and effects. Since the beginning of human civilization, dating as far back to the Egyptian time, there have been records showing the honey has indeed been used for aesthetic and medicinal purposes.

Top 7 Tips To Relieve Wrist Pain

You may not realize just how important your wrists are until one of them gets hurt. There are basically two types of wrist injury. One is acute, such as a sprain or a fracture. The other is overuse, caused by the repetitive motion of activities such as typing. The overuse injury that most often affects the wrists is tendinitis. People who use their hands a lot such as carpenters, computer operators, musicians can develop tendinitis if the tendons in their wrists are not strong and flexible enough. Overuse can also affect the ulnar nerve, which runs along pinkie side of the wrist and hand. And it can cause tissues in the wrist to swell and put pressure on the median nerve, leading to carpel tunnel syndrome. Both conditions can produce tingling, numbness, and pain in the fingers and hands as well as in the wrists. Here are some tips that you can consider to adopt to relieve wrist pain.

1. Build Some Muscles

You can prevent future wrist pain by strengthening the muscles in your forearms. It is recommended holding a 6-ounce can of tomato paste in each hand and flexing your wrists back and forth 15 to 20 times. Or you can simply squeeze a tennis ball in each hand. Squeeze the ball for 5 seconds and release, then repeat 12 to 15 times.

2. Ease Back Into It

A wrist that has been immobilized may become stiff from lack of use. Some gentle stretching can help restore flexibility. It is recommended pressing on a tabletop with the palm of your hand. Bend your wrist until you reach the angle of pain, then back off just a hair. By riding the edge of discomfort and stopping just before you feel pain, you are doing beneficial stretching. Hold this position or as long as you find comfortable, working up to 2 minutes. Repeat three to four times daily.

3. Treat It Gingerly

A compress made from ginger can draw out toxins and accelerate the healing process. To make the compress, simply boil some grated gingerroot, allow it to cool, place it in a moist washcloth, and lay the washcloth over your wrist. The washcloth should be as hot as you can tolerate. Leave it on for 15 to 20 minutes, and repeat every other hour.

4. Keep Still

For a more severe case of tendinitis, immobilizing the joint with an elastic wrist support may provide some relief. You will find these devices in drugstores and medical supply stores. It is recommended wearing one while you sleep, to prevent your wrist from twisting awkwardly as well as during your waking hours, when your wrist is in use. The support should keep your wrist in about 10-degree dorsiflex position. In other words, if your palm is facing downward, your wrist should be bent slightly upward.

5. Put It On The Rocks

Ice is a vasoconstrictor. That means it decreases the blood supply in your wrist, which helps reduce any swelling. It is recommended putting ice cubes in a plastic bag, wrapping the bag in a towel, and applying the pack to your wrist for about 20 minutes. Repeat the treatment four to six times a day.

6. Raise Your Hand

Elevation is not as crucial for an injured wrist as for an injured ankle or knee. Still, it can help keep any swelling down. Just be sure to prop your wrist so that it is above heart level.

7. Turn On The Heat

Once any swelling subsides, or if your wrist simply feels stiff and achy, heat can help. It is recommended to follow these instructions. Rub vinegar on your wrist, cover it with plastic, then apply a heating pad wrapped in a towel for about 20 minutes. You can repeat this treatment every hour as needed.

World Disable Day

The world is moving towards progress in every walk of life. But when we look towards societies, it feels as if some thing is still missing. Money, power, lust, etc., is the wish of every human being to attain. But we can’t deny this fact that we all are bounded with loads of social problems, which are hard nuts to crack. The key element of success and self- satisfaction is missing in most of the societies. Social issues are matters which directly or indirectly affect many or all members of a society and are considered to be problems, controversies related to moral values, or both. Social issues include poverty, violence, pollution, injustice, illiteracy, corruption, bribery, suppression of human rights, discrimination, and crime, child abuse, rape, dowry system, abortion, sex, etc.

Out of many social problems, I feel that the rights of Exceptional people are always being neglected by every one. No one wants to hear them. No body wants to give them proper love and care. They are being rejected from most of the societies. Due to the ill- behavior of the people, they are facing lots of trouble to explore their talents and creativity. Now, the time has arrived, when we need to re-think about our attitudes towards them. Tall talks from the government officials that special needs people will be given opportunities were held back by the previous government and still they are weeping for their rights to be given.

I did my research for 7 years at Aga Khan Social Welfare Board for Exceptional People Committee. I joined this institute and came to know about their feelings and emotions. I later studied many books and met many children of “Borderline Category” of different schools in Karachi. The revealing truth was bitter. I realized that they were totally deprived from our society and were considered as an insane, which is not true.

I guess, no one has right to define any human in their own perception, until and unless, he/she knows himself/herself deeply and perfectly. But it is a matter of despairty in Pakistan, that Exceptional Children are considered as a different being. People are trying to give their own definitions about them without knowing the proper definition of human. Human are acting like an animal and showing lack of concern towards them.

Let us try to understand, who exceptional people are?

Those persons who have IQ score which differ from the mean by two or more standard deviations are called Exceptional persons. Mentally retarded are declared as those persons who have scores two or more standard deviations below the mean. While the persons having score two or more standard deviations above the mean are called gifted persons.

Categories in respect of IQ are as follows:

o 70 above Border Line (trained and understandable)

o 70-50 Mild (educable)

o 50-35 Moderate (trainable)

o 35-20 Severe (miniman skills)

o 20-0 Profound (custodial care)

Thus we can say that,

“Exceptional children are those, who lacks either motor, cognitive, language, social and emotional, or self-help skill development.”

Imagine yourself sitting in Japan with the Japanese students communicating only in Japanese. How will you feel? At that moment, you will be called as a disable person who can’t speak or understand their language. But this is considered by you as a normal reaction, because you know you are normal. If that is the case, then how could most of us declare other mental without judging their talents and special skills, which God has bestowed them.

What disability is all about?

“Disability” means the lack of ability to perform an activity in a manner that is considered to be normal.”

“A disability is the expression of a physical or mental limitation in a social context- the gap between a person’s capabilities and the demands of the environment.”

(Pope and Tarlov, 1991 )

A person with disabilities means who, on account of injury, disease, or congenital deformity, is handicapped in undertaking any gainful profession or employment, and includes persons who are visually impaired as well. In short, Exceptional people are those, who either lacks one of the areas of development.

“Disability refers to the impact of impairment upon the performances or activities commonly accepted as the basic elements of every day living. Disability can be used when an impairment, objectively defined, constitutes a hindrance to mobility, domestic routines or the occupational and might be communicational skills.”

According to the social model,

“Disability is the outcome of the interaction of person and their environment and thus is neither person nor environment specific”.

Remember that physically disabled, blind/partially sighted, hearing impaired, autism, speech impairment, learning disabled, mild, moderate, severe, profound, borderline, etc., are some of the main categories of the Exceptional people out of many others. Persons with Exceptionality are mostly unseen, unheard and uncounted persons in Pakistan. They are the most marginalized group. Persons with special needs face overwhelming barriers in education, skills development and daily life.

The United Nations estimates that some 600 million people worldwide have a disability and that the vast majority of Exceptional people live in low and middle income countries. The proportion of Exceptional people in Pakistan as per census 1998 is 2.49 percent of total population, which is quite diverse from the estimates of World Bank, UN and WHO.

These children have equal right to freedom of expression, quality education and have access to a safe and healthy environment; in accordance with the Constitution of the Islamic Republic of Pakistan, 1973; to have full rights and obligations as citizens as confirmed in; the UN Declaration of Human Rights, 1948, on Education for All (1990), UN Standard Rules on Equalization of Opportunities of Persons with Exceptionality (1993), Salamnca Statement and Framework for Actions (1994), Dakar Framework for Action (2000), UN Millennium Development Goals (2001) and the National Policy for Persons With Disabilities (2002) guarantee the rights of all children, both with and without disabilities, to obtain quality education adapted to their individuals needs, abilities and aspirations and full equal participation in all other aspects of life such as participating in decisions and casting votes, etc.

But these claims proved to be false, when disable people raised their voice through media that how brutally they are being treated in Pakistani society.

Example: to attain quality education is the right for every disable, but still, no schools, colleges and universities have been setup by the government to cater their needs. Thanks to the private NGOs, who took an initiative and established few schools for the students with special needs.

The issue of Exceptionality is gaining more and more importance all over the world as well as in Pakistan. Due the movement for a rights based society initiated by many national organizations, World Bank and other donor agencies have included this issue in their mandates. Governments haves framed various policies including reservation jobs, concession facilities in traveling, special training institutions etc. But the question is, if these mandates were made, when it will be implemented, and who will implement it? No concession is being granted to any disable in Pakistan so far in any of the commodity, nor there is an institute, where they could learn skills free of cost. NGOs have set up institutions, which takes loads of money from the parents to support their child.

It has ratified several international conventions, promulgated the National Policy in 2002, begun revising the ordinance on employment which would raise the employment quota to two percent to ensure more job opportunities, and initiatives to develop “Inclusive Education”. But so far, no initiatives have been taken by any of the government.

An infrastructure for Inclusive Education and Training was established in Pakistan in the 1980s which far exceeds that of most of the developing countries. However, despite these efforts, the sad fact is that most people with disabilities and their families remain completely un-served by government – and even NGO resources. There is dire need of more accurate data and research on causes, prevention, and curative efforts to understand the social and economic realities and possibilities with regards to disability.

The major barrier to employment and other socio economic benefits for persons with Exceptionality in our society continues to be attitudinal barriers; stereotypical thinking and assumption about what people with disabilities can and can’t do. The truth is that, the range of abilities of persons within any Exceptional group is enormous. We need to get rid of our stereotypical images and view each “individual” as just that “an individual”.

Only limited categories of disabilities (physical disabilities such as amputations, foot and leg deformities, visual and hearing impairments) have been surveyed nationwide and most of the data has not been categorized by gender. Therefore, quantitative, nationwide, disaggregated data, by gender and age, is required for comprehensive policymaking and an assessment of progress. In Pakistan, there is only the ministry, responsible for social welfare and special education, which touch upon person with Exceptional issues. Moreover, Pakistani’s believe that persons with Exceptionality are a social burden and a curse on the family. These beliefs lead to the misunderstanding of disability. They prevent people from obtaining appropriate information and being educated. Employment opportunities for them are very limited and so they are a financial burden for their families.

Like us, Exceptional people are also bounded with some common problems, which they face in their day to day life.

Some of the problems of exceptional people are

o Hyperactivity;

o Distractibility;

o Impulsivity;

o Anxiety withdrawal;

o Fear and Phobias;

o Eating disorders;

o Echholahia;

o Movement problems;

o Depression;

o Suicidal Behavior;

o Difficult Temperament;

o Conduct Disorder;

o Aggression;

o Obsessions and Compulsions;

o Reluctant Speech;

o Elimination Disorder;

o Unresponsiveness to Suicidal Stimuli;

o Self Injury, etc.

Persons with disabilities face multiple social, economic, physical and political problems, which hampers their freedom of movement in society. These barriers include stigmatization and a misunderstanding of the abilities and aspirations of persons with disabilities. There is also a pronounced lack of informational data, rules and regulations, rehabilitation centers, and main streaming and specialized services for persons with Exceptionalities.

The major community problem for which I have contributed my efforts is for “THE RIGHTS OF SPECIAL PEOPLE”. I have worked as a teacher/counselor/trainer of Exceptional People for 7 years. Since my childhood, I had an intention to social work for the Exceptional people, because I had a natural bond of attachment with them.

I dealt with all types of student of Profound, Severe, Moderate and Mild category. But I especially worked with “Borderline” students, who want their rights; who are facing major problem in every society and in every community; who wants their creativity to explore in front of others; who awaits for the love from others and wants other to accept them as a Normal Being.

I believe that every individual can make a difference. I thank God that these lovely students trusted me, gave me the bond of relationship and accepted me whole-heartedly during my first year of Volunteer Service. They shared all of their problems with me and I thank God for giving me the special power for being accepted by them. I have heard their voices, their shivered pleadings, their wishes, their expectations. But still, they need every one in the society to hear them, to care them and to love them. While working for their RIGHTS, I also faced many difficulties in our society.

I can’t do every thing alone, but at least, I have brought a little change in their lives, which is a big reward for me. The problems, which need to be resolved wholly, could only be possible, if the societies will join their hands together.

o Media should take an initiative to discuss their issues to create awareness among the masses

o Inclusive education should be made compulsory in every school as the part of their curriculum.

o Awareness campaign for students’ parents’ teachers’ should be raised in every community.

o Job opportunities must be provided to disable people

o Their needs should be addressed.

o Awareness should be made through telecasting movies and drama on their issues.

o They should not be called special.

o Competition should be raised in every community for younger students to make them aware about their rights.

o They must get rights to study in normal schools with special needs.

o Government should setup new curriculum for them.

o Psychological testing should be made compulsory to identify their needs and areas of development.

o They must get work place opportunity, which is lack in Pakistan. They must get jobs in government institutions also.

Every one can contribute in the society:

o By participating in International competitions to raise awareness.

o By participating in awareness campaigns.

o By developing new curriculum for them on national policy level.

o By providing them educational facilities and social justice.

o By raising funds for them and by finding more work place opportunities for them.

o By becoming the Ambassador for Exceptional People in Pakistan.

o By truly implementing the human right laws, made by UN.

o By motivating them more enthusiastically.

Risks and Benefits of Plastic Surgery

Despite the slow economy in the United States, more Americans than ever are having plastic surgery. According to the American Society for Aesthetic Plastic Surgery (ASAPS) over 13 million procedures were performed last year. That’s up by 5%.

The most common surgeries are breast augmentation at 318,123, liposuction at 289,016, and blepharoplasty, or eyelid surgery at 152,123.

So why is plastic and cosmetic surgery so much in demand and what risks are people taking to get it?

The most obvious reason is that people want to look good and looking younger always helps in looking good. Plastic surgery boosts self-confidence. Not only do a person’s looks improve but he or she improves their attitude about themselves. Employers are more likely to hire them and others to find them attractive. If a person is overweight as well, weight loss surgery can help regain their youthful slimness faster and more permanently than dieting alone.

In today’s culture aging has no credibility at all. When so many multi-millionaires in Silicon Valley are under 30, getting older doesn’t even mean getting wiser, or more prosperous. In a recent study published by ASAPS people who had cosmetic surgery had no problems being identified by college students as 10 years younger than their actual age.

However, even with today’s technological advances, plastic surgery is still no cake walk. It is surgery and that carries automatic risks, such as:

  • blood clots
  • excessive or unexpected bleeding
  • infection
  • tissue death
  • paralysis
  • loss or change of sensation
  • incomplete healing
  • anesthesia malfunction
  • pneumonia
  • secondary surgeries
  • no satisfaction with results
  • nerve damage
  • obsession with more surgeries
  • high debt or bankruptcy due to cost

The last one should not be discounted. Though cosmetic surgery may be popular, a typical face lift costs between $4,000-$10,000 and a breast lift, between $3,000-$6,000 in the U.S. Unless it is associated with an accident or illness most employer insurance does not cover plastic surgery. Even countries that have government health insurance do not cover plastic surgery that is for cosmetic reasons only.

Saving on plastic surgery costs in Mexico

One way to cut costs considerably is to travel to Mexico. Places like Tijuana, Mexicali, Ciudad Juarez and Puerto Vallarta are very easy to reach from the U.S. and welcome foreign patients.

Bad news has been reported about charlatans in Mexico promising miracle cures, or offering unbelievably low prices. However, Mexico also has very professional, highly competent hospitals and doctors that can match the quality and standards of any in the U.S. Many are affiliated with American hospitals.

Plastic surgery costs performed by highly proficient surgeons, in clean and modern hospitals, with the state-of-the-art equipment can still come to as much as 90% lower than the cost of cosmetic surgery in the U.S. In many cases the hospitals will arrange pickup and delivery of patients from and to the border as well as airports or other transportation sites. Comfortable resort areas for recovery — away from violent or dangerous areas — can also be part of the package deal.

For those who believe they deserve to look as good as they feel — and have checked out the risks with their own doctors — travel to Mexico can make plastic surgery financially worth the effort.

Kitchen & Cooking Safety – Tips To Prevention And Treatment Of Cuts & Wounds, Burns, Falls & Strains

Injury or accident can occur at any place, at any time, be it in the work place or at home. These injuries (in this scope covers the minor injuries likely in a cooking environment) can be possibly prevented, and where it could not but happen can be effectively handled.

Below are the practical measures that should be observed to prevent or at least reduce to the barest minimum: cuts, falls, burns and strains. And where it occurs, some first aid measures (treatments).

Cuts: Always keep knives and use the right knife for the right job.

– Take precaution with sharp instrument; keep your fingers and other parts of your body from blade (sharp edge) or point.

– Keep shield on the sharp edges of tools and when not in use, store away in save place. Never keep knife loose with other cooking implements in a drawer.

– When cutting or chopping, ensure you do that, not on a stainless steel table, not even on your hand but on a board, and away from your body.

– Place a damp cloth under the board, where board slips and never try catching a falling knife.

– Never fool around with knife. Should you pass a knife to another, keep it pointed at the floor and not upwards.

– Wipe knife from the blunt side.

First Aid Treatment:

In the case of a minor cut, rinse wound under a cleaning running water or wash using clean water with an antiseptic like Dettol or Salvon until wound is clean, then put on a protective glove to avoid contamination.

Falls:

– Clean and dry the floor. The floor is usually slippery when wet or when fats, scraps, soap splash and drop or when nylon papers litter the floor.

– Wear non-slip shoes. Let your shoes have a good grip on the floor.

– Look where you walk. Avoid carrying large items as this might block your view and may cause you to lose your balance.

– Be sure to clear your runway of boxes, equipment, hose and wires, etc.

– Keep your mind on what you are doing. Walk purposefully but don’t run.

Strain: this means pulling the muscle in a wrong way or too suddenly, so the muscle gives way. This could be very painful as it can cause damage to the muscle. A strain in a pace like the stomach or chest could cause rupture of the internal lining, which can cause hernia that might require surgery. So

– Don’t lift heavy object without help. Use the trolley instead.

– Bend your knees, not your waist. Keep your back straight.

– Fetch it, don’t stretch for it.

– Don’t show off your strength. Work gradually, don’t go it once. Lift from floor to the chair and then to the counter.

First Aid Treatment For falls and Strains

Make the injured as comfortable as possible, apply cold compress (ice in a cloth). If any doubt about injury, treat as a fracture.

Burns Prevention

Unless you play it safe burns can occur working with any form of heat.

So beware of:

– Naked flame near your clothing or towel, electric heat near any part of your body, oil that fries too long and to hot, it can burst into flames.

– Boiling water too close to the top of your kettle or saucepan can boil over and splash.

– Don’t pick up a pan, pot or plate without checking the temperature.

– Keep papers, plastic aprons and other flammable materials away from hot areas and don’t try to do too many things at a time, stay calm and don’t be rushed.

– Use only natural gas or any other source designed for the purpose.

Treatments.

– Burns and scalds from steam must be cooled as soon as possible at least for ten minutes. This will reduce heat from the burn, swelling and pains as well as prevent further damage to underlying tissue.

– Blisters must not be removed. A wet cloth or ice wrapped in cloth may be used on the injury. Remove any thing on that part of the body before swelling occurs.

– Dress area with clean, sterile materials or bandage.

– Do not use adhesive dressings, plasters or cotton wool.

– Do not apply lotions or fat to the injury and never break blisters, remove loose skin or interfere with the injury.

The measures discussed above are intended for minor injuries alone. A qualified physician should handle major injuries professionally.

Acute and Chronic Sinusitis Treatments

It is estimated that 35 million people in the U.S. suffer from sinusitis. It is a major source of misery for the sufferers and can lead to depression, anxiety and mood disorders.

Acute Sinusitis

Definition

Acute sinusitis (inflammation of the sinuses) also known as acute rhinosinusitis does not last for more than 12 weeks.

Causes

The mucous membranes of the nasal passages become swollen and inflamed, the openings get blocked and proper sinus drainage is inhibited leading to a mucous build up. These blocked, inflamed sinuses create a moist environment that makes it easier for bacterial infection to occur and take hold. Usually a cold/flue or allergies cause the nasal congestion to occur.

Symptoms

Sinus/facial pain, sinus/facial tenderness, sinus/facial pressure, headaches, pain in teeth, pain in jaw, pain in ears, pain through and around eyes, fatigue, dizziness, drainage of a thick yellow or green discharge from the nose or down the back of the throat (post nasal drip), nasal congestion and difficulty breathing, reduced sense of smell and taste, cough (which may be worse at night), nausea, sore throat and halitosis (bad breath).

Treatments

1. Anti-biotics – A course of anti-biotics such as amoxicillan prescribed by a doctor usually gets rid of acute sinusitis.

2. Over the counter decongestant tablets and liquids – OTC decongestants such as Sudafed can relieve nasal congestion to help you breathe more easily. Like any medication they have side effects.

3. Over the counter decongestant nasal sprays – OTC nasal sprays such as Vicks Sinex can relieve inflammation and nasal congestion by shrinking blood vessels in the sinuses. These can cause side effects and should only be used short term (see manufacturers instructions) otherwise you can get rebound congestion (when you stop using it the congestion is worse than before) leading to dependency. Also prolonged use can lead to permanent damage of the delicate linings of the nasal passages and a condition called ‘Rhinitis Medicamentosa’.

4. Over the counter pain relievers – OTC pain relievers such as Aspirin and Ibuprofen can be used to relieve inflammation and pain. However they can cause side effects such as slowing down the digestive system and internal bleeding.

5. Natural nasal sprays – Natural nasal sprays such as SinuSoothe contain natural ingredients that relieve inflammation, sinus pain, headaches, nasal congestion, remove airborne irritants etc. It is also ant-bacterial and anti-fungal so can therefore help get rid of any infection present. For allergy sufferers it contains natural anti-histamines to relieve a runny, itchy nose and sneezing. It can be used long term, is non-addictive and has no side effects.

6. Saline nasal sprays – Saline nasal sprays such as Sterimar are useful for moisturising the nasal passages, removing airborne irritants and relieving congestion. These can be either isotonic or hypertonic solutions.These can be used long term and are non-addictive. They can help reduce inflammation.

7. Nasal irrigation – A neti pot is used to irrigate the sinuses with either an isotonic or hypertonic solution. An isotonic solution has the same salt concentration as your body. A hypertonic solution has a higher salt content and may be more useful at drawing moisture and mucous from the sinuses. This can help relieve nasal congestion and may reduce inflammation. This is a good practice for keeping the sinuses clean and many people have benefited from daily nasal irrigation.

Chronic Sinusitis

Definition

Chronic sinusitis, also known as chronic rhinosinusitis, lasts longer than twelve weeks or keeps coming back and people have been known to suffer from it for over fifty years. This can really have a profound affect on peoples quality of life.

Causes

The mucous membranes of the nasal passages become swollen and inflamed, the openings get blocked and proper sinus drainage is inhibited leading to a mucous build up. These blocked, inflamed sinuses create a moist environment that makes it easier for bacterial infection to occur and take hold.

It is caused by;

1. recurring bouts of acute sinusitis combined with a low immune system.

2. allergies.

3. fungal infections.

4. nasal polyps (growth in the sinuses) or tumours.

5. deviated nasal septum.

6. trauma to the face (a fractured or broken bone may obstruct the sinuses).

7. Medical conditions such as cystic fibrosis, gastroesophageal reflux, HIV and other immune system diseases.

8. Immune system cells (with certain health conditions immune cells called eosinophils can cause inflammation).

9. Regular exposure to pollutants such as cigarette smoke.

Symptoms

Sinus/facial pain, sinus/facial tenderness, sinus/facial pressure, headaches, pain in teeth, pain in jaw, pain in ears, pain through and around eyes, fatigue, dizziness, drainage of a thick yellow or green discharge from the nose or down the back of the throat (post nasal drip), nasal congestion and difficulty breathing, reduced sense of smell and taste, cough (which may be worse at night), nausea, sore throat and halitosis (bad breath). The fatigue is worse in chronic sinusitis than acute sinusitis.

Treatments

1. Anti-biotics – Unfortunately anti-biotics do not get rid of chronic sinusitis. The Mayo Clinic in the U.S. have conducted clinical trial and discovered that 96% of people with chronic sinusitis have a fungal infection. There is a theory that this fungal infection irritates the sinus passages and they become inflamed. That is why anti-biotics prescribed to treat chronic sinusitis do not work since they cannot kill the fungal infection. In fact since anti-biotics themselves are a mold, they can make fungal infection worse (which may make chronic sinusitis worse).

2. Nasal corticosteroids – Steroid nasal sprays such as Beconase can reduce inflammation for sinusitis and allergy sufferers, usually start to work within a few hours, and are used twice a day at most. They are particularly useful at reducing nasal polyps. However they can cause side effects such as nasal ulcers, cataracts, headaches, sore throat etc. and they do not treat any underlying infection.

3. Oral or injected corticosteroids – These are used for severe sinusitis. They can cause severe side effects and do not treat underlying infection.

4. Over the counter decongestant tablets and liquids – see acute sinusitis.

5. Over the counter pain relievers – see acute sinusitis.

6. Natural nasal sprays – see acute sinusitis.

7. Saline sprays – see acute sinusitis.

8. Nasal irrigation. see acute sinusitis.

9. Over the counter decongestant nasal sprays – These are not suitable for chronic sinusitis since they should not be used on a long term basis.

10. Over the counter pain relievers – see acute sinusitis.

11. Non-steroid nasal sprays – Non-steroid nasal sprays such as NasalCrom can relieve allergies by reducing histamine production in the nasal tissue. If nasal congestion is present the sinuses have to be cleared before using it by either blowing your nose or or using a decongestant nasal spray. This type of nasal spray is not always successful and can have side effects such as headaches, drying of nasal tissue, swelling of face etc.

12. Over the counter anti-histamines – These are available as tablets or syrups such as Benadryl. They can reduce the amount of histamine produced during an allergic reaction thereby reducing the symptoms such as nasal congestion. However they can cause various side effects such as drowsiness.

13. Nasal anti-histamines – Nasal anti-histamines such as Astelin are steroid free and help patients to be symptom free from their allergies for up to 12 hours. They can however cause side effects such as headaches, drowsiness etc.

14. Reducing stress levels – Stress contributes to ill health and should be avoided whenever possible. It reduces immune function and can aggravate any medical condition. Vitamin B complex assists the body during stressful times and magnesium can relax you. There are also plenty of other herbs and supplements that can relieve stress. Your local health food store should be able to advise you. Pressure is healthy, stress is not.

15. Exercise – Exercise has been known to reduce chronic sinusitis symptoms since the endorphins released during exercise act as natural painkillers. It can also improve immune function provided it is not over strenuous.

16. Boosting immune system – Eating a balanced diet and supplementation with vitamins and minerals will improve the immune function and the ability to fight off infection. Vitamins; vitamin C, B complex, multi-vitamin and garlic.

17. Natural anti-inflammatories – Since inflammation causes the symptoms of sinusitis it is logical that anti-inflammatories will reduce inflammation therefore relieve the symptoms. Omega 3,6 & 9 oils, vitamin C, turmeric and ginger are all excellent natural anti-inflammatories. There are plenty of others and your local health food store should be able to advise you on these. It usually takes about 4 weeks for these to start taking effect.

18. Natural anti-histamines – For chronic sinusitis caused by allergies, quercetin and butterbur etc. can be just as effective as OTC anti-histamines but they do not have their undesirable side effects. It usually takes about 4 weeks for these to start taking effect.

19. Pollen barriers – For sinusitis caused by hayfever, pollen barriers such as petroleum jelly or special barrier gels inside the nostrils can catch pollen before it enters the nasal passages.

20. Red light phototherapy – This involves inserting two narrow red light probes in to your nostrils. The light reduces inflammation in the nasal membranes.

21. Immunotherapy – This is often a last option for allergy sufferers. Very small amounts of the allergen you are allergic to is either injected in to your body or ingested in a tablet form, to gradually desensitize your immune system to the allergen. You have to be referred to an allergy clinic in order to receive this treatment.

22. Surgery – Surgery can be carried out to remove a nasal polyps, rectify deviated septum or remove infected unhealthy sinus tissue. Surgery should be considered as a last resort for chronic sinusitis as any form of surgery carries a risk and it is not always guaranteed to work.

As with all medical conditions you should consult your doctor and any specialist before embarking on new treatments.

Bulimia Effects on the Brain – The Simple Steps to Reverse it

Bulimia can affect the brain in several ways. First, it enslaves the attention system. The longer one has bulimia the more his/her attention system suffers. In some cases people even drop out of school, universities, give up on good jobs – all due to their inability to maintain attention and concentrate on their work.

In bulimics, food over-stimulates the attention centers represented through the central nervous system. The abnormal activation creates a state of emergency which brings forth the manifestation of the sympathetic nervous system (fight and flight response) when people think about binging food. As a result, the nervous system has to liberate more energy. The additional flow of energy into the human nervous system gives a feeling of relaxation or a floating feeling called a “high” during the binge.

When the binge finishes, the sufferer is soon drained out of energy and this causes a kind of a hangover and total depression of their attention factors this is the state between binges. The oscillation from over-flow to depression takes their attention fully and registers a shock on the central nervous system. That is why bulimics have difficulty maintaining attention on anything else except of food and binging. Such repeated experiences create enslavement of their attention and destroys their brain cells at the same time.

Secondly on a physiological level, brain function may be impaired as the sufferer doesn’t have enough glucose, lipids or other molecules that can be broken down for energy. Sometimes, in severe cases the brain even starts to consume its own tissue to get the energy. That’s why in chronic sufferers the brain may shrink as a result of lipids in the brain being broken down for energy. This can result in serious brain damage.

These people feel lethargic, confused, powerless and helpless. They can experience headaches, neck pains, back pains and other uncomfortable sensation in their bodies. Often, their aches and pains are of a psycho-somatic origin and not physical.

The brain can also suffer because of the effects caused by electrolyte imbalances. When people purge they lose enormous amount of important chemicals (electrolytes) which makes brain function slow or even impossible depending on the total loss.

Third, on a psychological level the brain is damaged by abnormal thinking patterns as the individual believes that they are overweight when they are clearly severely underweight or normal. Bulimics also have a fear of putting on weight. These abnormal thinking patterns are so strong that they overpower all other thinking processes. That’s why bulimics get so preoccupied with food, weight and body image.

To conclude, bulimia definitely changes the brain structure to an unhealthy level. It makes the brain think, differently, work differently, function and process information differently. The process of changing the brain is called neuroplasticity. Neuroplasticity can be bad, but can be good it depends how the sufferer chooses to use it.

If bulimics start using neuroplasticity in a positive way they can reverse the damage which has been done by the bulimia and return their brain to a healthy level. And not just that; they can make their brain work like the brain of a genius if they use neuroplasticity correctly.

Type 2 Diabetes – When Should You Stop Eating Before Bedtime?

It’s 10pm…do you know where your diabetes snacks are? For many Type 2 diabetics, nighttime hunger pangs are a hair-pulling experience. While your neighbor may be able to raid his cupboard for whatever he fancies at the moment, you’re forced to dole out portions and count carbs.

While your diabetes diet doesn’t drastically change when Jay Leno comes on, the timing of your meals do. Eat too soon before bed, and you might as well add the pounds to your midsection yourself. Go to bed hungry, and you may wake up with the dreaded dawn phenomenon… the unexpected rise in blood sugar that oftentimes takes place when diabetics go to bed after a significant fast.

These tips will help answer the classic diabetes head-scratcher: “When should I stop eating before bedtime?”

1. Free Foods Don’t Matter: So-called free foods, such as celery, diet soda, and sugar-free Jell-O don’t count for or against you at night. Because they contain virtually no carbs (or calories), you can eat these before bedtime if you’d like… but be sure not to expect them to count against the dawn phenomenon.

On the other hand, if you’ve already had a carb or calorie-heavy day, free foods are a perfect way to quench your grumbling belly and avoid a sugar rush.

2. Study History: It’s impossible for anyone to hand you an exact minute by minute account of when it’s OK to eat before bedtime and when it’s off limits. That’s why most diabetes experts recommend not just checking your blood sugar levels often… but writing them down.

With this information at hand, you can answer the question: what happened last time I had 2 handfuls of peanuts and an apple 2 hours before bed? This is the only way to actually know whether your bedtime snack gets the green light or not.

It’s not a perfect science, but it will give you a much more accurate way of determining things than relying on generic guidelines.

3. Eat If You’re Hypo: It doesn’t matter what time it is… if your blood sugar levels are low, especially if you’re on insulin, eat something. Many diabetics go to bed hungry with hypoglycemia because they were nervous about eating before bed. This isn’t wise.

4. About 3 Hours Before Bed, Eat Something: Having a nighttime snack about 2 to 3 hours before bed is as specific as anyone can get. Think about it this way: if you had dinner at 6pm, went to bed at 11pm, and woke up at 7:30Am, that’s more than 12 hours without eating a thing!

This will inevitably cause your body to shoot out internal stores of glucose, potentially making you hyperglycemic during the night.

Be sure to account for a small, protein-rich bedtime snack, like chicken and greens or nuts and veggies into your diet.

With these guidelines, bedtime eating should be as simple and straightforward as the rest of the day.